@Phloston wrote up his CS experience here:
http://forums.studentdoctor.net/thr...-thoughts-and-experience-by-phloston.1146002/
My advice: Read FA Step 2 CS. Practice writing a couple notes in the 10 minute time limit. The USMLE website has a note template that looks exactly like what you'll see on test day. I found that the time didn't bother me, but the space limit in the HPI was too short for me in pretty much every encounter. ROS, PMH, FH, SH, Meds, Allergies go in the History box along with the HPI, and you only have 950 characters, so it's cramped (Tip: don't make a new line for each part of the history. Each line is 2 characters instead of 1. Just write PMH: blah blah blah. FH: blah blah blah all in one line). If you feel like you need more practice, find a friend to practice with - they can pretend to be the SP and use the cases in First Aid.
I haven't gotten my results yet, but [Update: Passed with high performance on CIS and SEP, mid-range performance on ICE] I felt really well prepared just from the OSCEs and practice CS my school provided as well as reading through FA for a couple days before the test.
- I made a list of the parts of the encounter that I HAD to do every single time (everything apart from pertinent history and physical that would change from patient to patient), and I went over them in my head when I read through each case so that they became ingrained.
- Introduce yourself by your first AND LAST name as well as your role (doctor or medical student is fine)
- Smile and shake the patient's hand
- Ask CAGE questions if they're a moderate/heavy drinker
- Counsel about smoking, excessive drinking, unprotected sex and pregnancy. FA has a good summary about doing this and the questions to ask.
- Summarize history before moving on to physical
- Wash hands before physical
- Talk about what you think might be going on
- Talk about what diagnostic studies you are ordering
- Ask if the patient has any questions or concerns
- Answer their question
- Ask them again if they have any questions
- Repeat until all questions are answered
- Thank them, shake hands, leave room
- Use your empathetic statements.
- If the 5 minute warning comes on and you haven't done the PE yet, do the PE very focused and very quickly. Like ONLY do the pertinent exam for the affected organ system and move on to the closure. I always left at least ~3 minutes for closure. Closure is more important than PE.
- I made sure to have fun with it. You're supposed to be acting like at least an intern, so act like an intern.
- Once I left the room and finished the note, I put that encounter completely out of my mind. Yeah maybe I forgot a physical exam maneuver or I could have said something else to the patient, but at that point there was nothing I could do about it, and I would be better served to focus my energy on the next encounter.
- Once I left the 12th station, I put the entire test out of my mind. Again, can't change anything that happened and can't do anything but twiddle my thumbs until the results come in, so no point in dwelling on the little things I missed.
Also, something I hadn't known before the little orientation that morning is that you need special permission to have medication or medical devices with you. I didn't need anything, but if you need something like that during the test day, look into it on the website. They make you lock up your belongings and you can't access them until the test is over.
They feed you lunch after the 6th encounter (30 min break). It was a pretty decent spread.
You get 2 other breaks, one after the 3rd encounter and one after the 9th. They're 10 minutes each.
Chat with the other test takers during breaks. I met some cool people, even a couple people from different countries.
Don't stress about it. Get practice if you feel like your interpersonal skills or efficiency need work.
